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The effect of heart rate on coronary plaque measurements in 320-row coronary CT angiography

Abstract

Repeatability of quantitative assessment of atherosclerotic plaques is important for the accurate detection of high-risk plaques in coronary CT angiography (CTA). We assessed the effect of heart rate (HR) on plaque CT number using a coronary artery model and a cardiac phantom capable of simulating cardiac motion. The coronary artery model with luminal stenosis on a cardiac phantom was imaged with a simulated HR of 0, 50, 60, and 70 beats per minute using a 320-row CT scanner. We reconstructed CT images for cardiac diastolic phases (for 75% R–R interval) using filtered back projection (FBP), hybrid iterative reconstruction (AIDR3D), and model-based iterative reconstruction (FIRST). Two observers measured plaque attenuation in the lesion with 75% stenosis. The coefficient of determination (R2) was obtained to evaluate interobserver agreement. At HR 70, FIRST improved the correlation between two observers compared with FBP and AIDR3D (FIRST: R2 = 0.68, p < 0.05; FBP: R2 = 0.29, p = 0.31; AIDR3D: R2 = 0.22, p = 0.18). These R2 at HR 70 were lower compared with at HR 50 (FIRST: R2 = 0.92, p < 0.05; FBP: R2 = 0.83, p < 0.05; AIDR3D: R2 = 0.87, p < 0.05) and HR 0 (FIRST: R2 = 0.97, p < 0.05; FBP: R2 = 0.89, p < 0.05; AIDR3D: R2 = 0.95, p < 0.05). Higher HR affected plaque measurement repeatability in coronary CTA. FIRST may improve plaque measurement repeatability at the higher HR compared with FBP and AIDR3D.

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Abbreviations

CTA:

Computed tomography angiography

HU:

Hounsfield unit

IVUS:

Intravascular ultrasound

HR:

Heart rate

BPM:

Beats per minute

FBP:

Filtered back projection

AIDR3D:

Adaptive iterative dose reduction 3D

FIRST:

Forward projected model-based iterative reconstruction solution

ROI:

Region of interest

SD:

Standard deviation

ICC:

Intraclass correlation coefficients

LoA:

Limits of agreement

CAD-RADs:

Coronary Artery Disease Reporting and Data System

MD:

Mean difference

ms:

Milliseconds

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Correspondence to Masafumi Kidoh.

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Kidoh, M., Utsunomiya, D., Funama, Y. et al. The effect of heart rate on coronary plaque measurements in 320-row coronary CT angiography. Int J Cardiovasc Imaging 34, 1977–1985 (2018) doi:10.1007/s10554-018-1415-0

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Keywords

  • Coronary computed tomography angiography
  • Coronary artery disease
  • Coronary artery plaque
  • Non-calcified plaque
  • Model-based iterative reconstruction